A survey of laboratory ‘critical (alert) limits’ in the UK

Ann Clin Biochem 2003;40:181-184
© 2003 Association for Clinical Biochemistry


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J. Tillman and
J. H. Barth

Department of Clinical Biochemistry and Immunology, Leeds General Infirmary, Leeds LS1 3EX, UK;
Department of Clinical Biochemistry and Immunology, Leeds General Infirmary, Leeds LS1 3EX, UK

Introduction: Critical or alert limits are the values of laboratorymeasurements that are regarded as requiring urgent clinicalaction and should be communicated to a clinician urgently. Despitethis, there has been little evaluation of these values in theUK.

Methods: We have conducted a survey of hospital biochemistrylaboratories in the UK.

Results: Ninety-four laboratories responded to the questionnaire;the response rate was not recorded. Twenty-three laboratorieshad derived their action limits locally from a consensus withtheir clinicians, experience over many years, and the literature.Only two laboratories quoted literature to support their values.Seven laboratories did not submit actual critical values. Therewas considerable variance in the values defined as criticalby the responding laboratories.

Discussion: Each laboratory needs to evaluate its own list ofacutely important critical values and aim for a small numberof analytes that are always communicated to the doctor, so thatclinical needs are met without raising the risk of informationoverload.

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